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General NPI Number Information
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NPI Number | 1033095450
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Entity Type | Organization
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Legal Business Name | PRIYA MISTRY DDS PC
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Dates
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Enumeration Date | 08/12/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 16415 SE 15TH ST SUITE 103
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City | VANCOUVER
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State | WA
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Zip | 98683
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Country | US
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Telephone | 503-255-8293
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Fax | 503-252-1214
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Provider Business Mailing Address
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Address Line | 12518 SE 24TH ST
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City | VANCOUVER
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State | WA
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Zip | 98683
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Country | US
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Telephone | 425-256-0481
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | PRIYA PATIL MISTRY
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Credential | DDS
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Telephone | 503-255-8293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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